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Idiopathic Acute Pancreatitis and Sphincter of Oddi Dysfunction: Diagnostic and Therapeutic Role of ERCP and Sphincter of Oddi Manometry

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Abstract

Despite advances in cross-sectional imaging and a deeper understanding of the genetic and epigenetic factors associated with acute pancreatitis (AP), up to 20 % of cases remain idiopathic. Of these, many patients are at risk of having multiple episodes and progressing to chronic pancreatitis. Classically, AP is idiopathic when no etiology is identified after a negative history, physical, basic laboratories, and cross-sectional imaging. Improvements in less invasive pancreatic imaging, an evolving understanding of autoimmune pancreatitis, and better genetic tests have impacted the threshold after which endoscopic retrograde cholangiopancreatography (ERCP) should be utilized in the diagnostic work up of unexplained AP. Furthermore, the role of ERCP as a therapeutic modality remains unclear. In this chapter, we will discuss the diagnostic yield and therapeutic impact of ERCP in the management of idiopathic AP and sphincter of Oddi dysfunction (SOD).

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology & Hepatology, Indiana University, 72 Rotary Circle, Indianapolis, IN 46202, USA

    Ji Young Bang MD, MPH

  2. Department of Medicine, Division of Gastroenterology, Medical University of South Carolina, 114 Doughty St. MSC 702, Suite 249, Charleston, SC 29425, USA

    Assoc. Prof. Gregory A. Coté MD, MS

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  1. Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Linda S. Lee

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Video 14.1 Pancreatic sphincterotomy

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Bang, J., Coté, G. (2015). Idiopathic Acute Pancreatitis and Sphincter of Oddi Dysfunction: Diagnostic and Therapeutic Role of ERCP and Sphincter of Oddi Manometry. In: Lee, L. (eds) ERCP and EUS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2320-5_14

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